Do more CT scans lead to more kidney surgeries?

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About one in fifty people reading this essay will be diagnosed with kidney cancer at some time in their life. In fact, one out of one people writing this essay has already been diagnosed with kidney cancer. (I had a small tumor removed from my left kidney not long after I turned 50.) But how many people […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.

CONCLUSION: Avelumab can induce interstitial lung disease. The mechanism is uncertain and requires further studies. Monitoring of respiratory function and CT scanning are necessary for its early management.
PMID: 30318432 [PubMed - as supplied by publisher]

Rationale:
Mucinous tubular and spindle cell carcinoma (MTSCC) is a variant of renal cell carcinoma newly added to the WHO classification in 2004. It is a rare variant of renal cell carcinoma and sometimes it is not easy to distinguish MTSCC from papillary renal cell carcinoma, chromophobe renal cell cancer, etc. The prognosis of MTSCC is favorable after surgical resection.
Patient concerns:
A 45-year-old male patient presented with a right renal mass that was detected on ultrasonography incidentally. The computed tomography scan showed a huge homogenous mass with patchy calcification in the central area, and the lesi...

CONCLUSIONS: Using an abbreviated CT protocol that includes the chest and upper abdomen for surveillance after surgery of localized kidney cancer decreases radiation exposure by half with only a minor decrease in the sensitivity of the examination.
PMID: 30228095 [PubMed - as supplied by publisher]

The current protocols for surveillance following surgery for localized renal cell carcinoma (RCC) stratify patients according to risk groups [1 –4]. Periodic computed tomography (CT) scans of the chest and abdomen are recommended according to risk groups with some variations between the different guidelines. Given that CT is a very sensitive tool for detection of early and potentially curable metastasis and local recurrence [5–8], over the evolution of successive guideline recommendations more and more CT studies have been added to the protocols [1].

Five years ago, Dawnia, who lives in Texas, was diagnosed with stage II kidney cancer at age 50. During a routine visit at her gynecologist ’s office, the nurse practitioner was alarmed when she learned that Dawnia’s mother was recently diagnosed with kidney cancer. The nurse urged her to get an ultrasound which showed a 9×9 tumor. Dawnia credits her nurse practitioner’s suggestion of getting an ultrasound with saving her life. S he has remained cancer-free following her nephrectomy. No chemotherapy or radiation was required. Dawnia had chest x-rays and abdominal CT scans every three to six months f...